P1644 - Adherence to Recommended Healthcare Maintenance Guidelines by IBD Providers in a Tertiary Care Center

Molly Stone, MD, Erin M. Forster, MD, MPH
Medical University of South Carolina, Charleston, SC

Introduction: Patients with Inflammatory Bowel Disease (IBD) have unique healthcare maintenance requirements outlined in the 2017 American College of Gastroenterology (ACG) guidelines. Despite these recommendations, patients with IBD receive routine healthcare at lower rates than healthy peers. This is multifactorial including patient perception of their gastroenterologist (GI) as a primary care provider (PCP), PCP unfamiliarity with recommendations, poor access to care and lack of effective communication between their GI and PCP. We aimed to assess the performance of IBD providers adherence to the guideline recommendations in order to identify areas for improvement.

Methods: A retrospective chart review was conducted of all patients with a diagnosis of Crohn’s Disease (CD), Ulcerative Colitis (UC) or Inflammatory Bowel Disease Unspecified (IBDU) who were seen by an IBD provider in a 24 month period at a tertiary care center in a low-income state. Information was abstracted from the electronic medical record (EMR) including smoking and vaccination status, and cancer, depression and osteoporosis screening. Up-to-date (UTD) determinations were based on ACG guidelines. This fell under exemption from the IRB.

Results: A total of 1280 patients (869 CD, 296 UC, 115 IBDU) were included. Smoking status was recorded in >99% and depression screening was recorded in 74% of patients with 55% of all patients being UTD. In all IBD patients, 35% were UTD on TDap and 55% were UTD on influenza. Patients on biologic agents (N=780) overall had poor completion of recommended vaccinations with only 5% having HPV, < 50% for pneumococcal, and < 1% for herpes zoster. Cervical cancer screening was UTD in 7% of immunosuppressed and 41% of non-immunosuppressed women. Age-based DEXA screening was UTD in 41% of women and 13% of men.

Discussion: Patients with IBD were behind on many of the ACG recommendations. There were pronounced deficiencies in pneumococcal and zoster vaccination and cervical cancer screening. There was a strength in depression screening, particularly important given the prevalence of comorbidity with IBD. This study highlights the need for continued efforts to provide appropriate preventive health screenings to patients with IBD as a joint effort between PCP and GI particularly in low-income areas with additional barriers to care. “Hard-stop” checklist documentation in the EMR may help ameliorate these deficiencies going forward.


Table: Table 1. Demographic and Preventive Health Measures


Disclosures:
Molly Stone indicated no relevant financial relationships.
Erin Forster: Abbvie – Advisory Committee/Board Member, Speaker's Bureau. BMS – Advisory Committee/Board Member, Grant/Research Support. Janssen – Grant/Research Support. Prometheus – Stockholder/Ownership Interest (excluding diversified mutual funds). Takeda – Grant/Research Support.


Molly Stone, MD, Erin M. Forster, MD, MPH. P1644 - Adherence to Recommended Healthcare Maintenance Guidelines by IBD Providers in a Tertiary Care Center, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.